Breast Implant Associated Anaplastic Large Cell Lymphoma, (BIA-ALCL) Review Article

Hessami, R; Hafezi, F

Breast Implant Associated Anaplastic Large Cell Lymphoma, (BIA-ALCL) Review Article

Document Type : Review Article

Authors

R Hessami ¹

F Hafezi ²

¹ Plastic and Reconstructive Surgeon, Iran University of Medical Sciences, Burn Research Center, Fatima Hospital, Tehran, Iran

² Professor, Department of Reconstructive and Plastic Surgery, Iran University of Medical Sciences, Burn Research Center, Hazrat Fatemeh Hospital (SA)

Abstract

BI-ALCL is an uncommon T-cell lymphoma. In 2011 FDA suggested that breast implants are possibly associated with development of BI-ALCL, since then more cases of BI-ALCL were reported. It is estimated that to this date more than 500 cases have been diagnosed as BI-ALCL around the world. In most of these cases implant surface was textured rather than smooth. Both silicone and saline filled implants have been reported to develop this problem. BIA-ALCL has two different presentations. Two-thirds of the cases present as periprosthetic fluid collection one year or later after implant insertion, and the remaining one-third as a capsular mass around breast implant. These presentations seem to be different stages of one disease. Although the best imaging-based screening is not identified, sonography, PET and CT are appropriate methods. Mammography has low sensitivity for screening of BI-ALCL. Every suspicious case should be confirmed with fine-needle aspiration and pathological examination for IHC (CD30) with insistence to rule out BI-ALCL before surgery. Operative treatment of confirmed cases should include removal of bilateral implants, total capsulectomy, and complete excision of any suspicious lymph node. The role of adjuvant treatments is under investigation. Although BIA-ALCL is rare lymphoma of breast, early diagnosis and appropriate treatment is necessary in the patients. Death has been reported in 9 patients in the U.S.

Keywords

Textured Implant

Delayed Complication

Breast Lymphoma

1. Keech JA, Creech BJ. Anaplastic T-cell lymphoma in proximity to a saline-filled breast implant. Plast Reconstr Surg. 1997; 100(2): 554-555.

2. Anaplastic large cell lymphoma (ALCL) in women with breast implants: preliminary FDA findings and analyses. U.S. Food and Drug Administration, 2011. [Online] Available from: www.fda.gov.

3. Clemens MW, Horwitz SM. NCCN Consensus Guidelines for the Diagnosis and Management of Breast Implant-Associated Anaplastic Large Cell Lymphoma. Aesthet Surg J. 2017; 37(3): 285-289.

4. IARC monographs on the evaluation of carcinogenic risks to humans. Report of the Advisory Group to Recommend Priorities for IARC Monographs during 2015–2019, April 18, 2014. [Online] Available from: <http://monographs.iarc.fr>.

5. Treatment for health professionals. US National Cancer Institute. [Online] Available from: <http://www.cancer.gov/>.

6. Institut National du Cancer. Agence Nationale de Sécurité du Médicament. Breast implant associated anaplastic large cell lymphoma: expert opinion, February 1, 2015.

7. Clemens MW, Miranda RN. Coming of age, breast implant – associated anaplastic large cell lymphoma after 18 years of investigation. Clin Plast, Surg. 2015; 42(4).

8. Australian Therapeutic Goods Administration. Breast implants: Update on TGA monitoring of anaplastic large cell lymphoma. <https://www.tga.gov.au/alert/breast-implants- update
tgamonitoring-anaplastic-large-cell-lymphoma>.

9. Campanale A, Boldrini R, Marletta M. 22 Cases of Breast Implant-Associated ALCL: Awareness and Outcome Tracking from the Italian Ministry of Health. Plast Reconstr Surg. 2018 Jan; 141(1):
11e-19e.

10. Johnson L, O'Donoghue JM, McLean N, et al. Breast implant associated anaplastic large cell lymphoma: The UK experience. Recommendations on its management and implications for informed consent. Eur J Surg Oncol. 2017 Aug; 43(8):
1393-1401.

11. De Jong D, Vasmel WL, de Boer JP, et al. Anaplastic large-cell lymphoma in women with breast implants. JAMA. 2008; 300: 2030-2035.

12. General information about adult non-hodgkin lymphoma. National Cancer Institute, 2014. [Online] Available from: <https://www.cancer.gov/ types/lymphoma/patient/adult-nhl-treatment-pdq>.

13. Stein H, Mason DY, Gerdes J, et al. The expression of the Hodgkin’s disease associated antigen Ki-1 in reactive and neoplastic lymphoid tissue: evidence that Reed-Sternberg cells and histiocytic malignancies are derived from activated lymphoid cells. Blood. 1985; 66: 848-858.

14. Jacobsen E. Anaplastic large-cell lymphoma,
T-/null-cell type. Oncologist. 2006; 11: 831-840.

15. Cao YB1, Wang SS, Huang HQ. Primary breast lymphoma–a report of 27 cases with literature review. Ai Zheng. 2007; 26(1): 84-89.

16. Gholam D1, Bibeau F, El Weshi A. Primary breast lymphoma. Leuk Lymphoma. 2003; 44(7):
1173-1178.

17. Kim B, Roth C, Chung KC, et al. Anaplastic large cell lymphoma and breast implants: a systematic review. Plast Reconstr Surg. 2011; 127: 2141-2150.

18. Clemens MW, Miranda RN. Commentary on: lymphomas associated with breast implants: a review of the literature. Aesthet Surg J. 2015; 35(5):
545-547.

19. Kim B, Roth C, Young VL, et al. Anaplastic large cell lymphoma and breast implants: results from a structured expert consultation process. Plast Reconstr Surg. 2011; 128: 629-639. The authors conducted.

20. Yoshida SH, Swan S, Teuber SS, Gershwin ME. Silicone breast implants: immunotoxic and epidemiologic issues. Life Sci. 1995; 56(16):
1299-1310.

21. Ferreri AJM, Govi S, Pileri SA, Savage KJ. Anaplastic large cell lymphoma, ALK-negative. Crit Rev Oncol Hematol. 2013; 85(2): 206-215.

22. Gaudet G, Friedberg JW, Weng A, et al. Breast lymphoma associated with breast implants: two
case-reports and a review of the literature. Leuk Lymphoma. 2002; 43: 115-119.

23. Hart AM, Lechowicz MJ, Peters KK, et al. Breast implant-associated anaplastic large cell lymphoma: report of 2 cases and review of the literature. Aesthet Surg J. 2014; 34(6): 884-894.

24. Lipworth L, Tarone RE, McLaughlin JK. Breast implants and lymphoma risk: a review of the epidemiologic evidence through 2008. Plast Reconstr Surg. 2009; 123: 790-793.

25. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/ BreastImplants/ucm481899.htm.

26. de Jong D, Vasmel WL, de Boer JP, et al. Anaplastic large-cell lymphoma in women with breast implants. JAMA. 2008; 300: 2030-2035

27. Largent J, Oefelein M, Kaplan HM, et al. Risk of lymphoma in women with breast implants: analysis of clinical studies. Eur J Cancer Prev. 2012; 21:
274-280.

28. Brinton LA. The relationship of silicone breast implants and cancer at other sites. Plast Reconstr Surg. 2007; 120(7 suppl 1): 94S-102S.

29. Lipworth L, Tarone RE, McLaughlin JK. Breast implants and lymphoma risk: a review of the epidemiologic evidence through 2008. Plast Reconstr Surg. 2009; 123(3): 790-793.

30. Loch-Wilkinson A, Beath KJ, Knight RJW. Et al. Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand:
High-Surface-Area Textured Implants Are Associated with Increased Risk. Plast Reconstr Surg. 2017 Oct; 140(4): 645-654.

31. Australian Therapeutic Goods Administration. Breast implants: Update on TGA monitoring of anaplastic large cell lymphoma. https://www.tga.gov.au/alert/breast-implants-update
tgamonitoring- anaplastic-large-cell-lymphoma>.

32. Zakhary JM, Hamidian Jahromi A, Chaudhery S, Kim M. Anaplastic large cell lymphoma in the setting of textured breast implant: a call for patients andphysicians education. J la State Med Soc. 2013; 165: 26-29.

33. Clemens MW, Medeiros LJ, Butler CE, et al. Complete surgical excision is essential for patients with breast implant-associated anaplastic large cell lymphoma. J Clin Oncol. 2015: 160-168.

34. Nava MB, Adams WP Jr, Botti G, MBN 2016 Aesthetic Breast Meeting BIA-ALCL Consensus Conference Report. Plast Reconstr Surg. 2018 Jan; 141(1): 40-48.

35. Beatriz EA, Miranda RN, Rauch GM, et al. Breast implantassociated anaplastic large cell lymphoma: sensitivity, specificity and findings of imaging studies in 44 patients. Breast Cancer Res Treat. 2014; 147(1): 1-14.

36. Bengtson BP, Van Natta BW, Murphy DK, et al. Style 410 highly cohesive silicone breast implant core study results at 3 years. Plast Reconstr Surg. 2007; 120: 40S-48S.

37. Hammond DC, Migliori MM, Caplin DA, et al. Mentor Contour Profile Gel implants: clinical outcomes at 6 years. Plast Reconstr Surg. 2012; 129: 1381-1391.

38. Maxwell GP, Van Natta BW, Murphy DK, et al. Natrelle style 410 form-stable silicone breast implants: core study results at 6 years. Aesthet Surg J. 2012; 32: 709-717.

39. Spears S, Murphy D, Slicton A. Inamed silicone breast implant core study results at 6 years. Plast Reconstr Surg. 2007; 120: 8S-16S.

40. Cunningham B. The Mentor Core Study on silicone MemoryGel breast implants. Plast Reconstr Surg. 2007; 120: 19S-29S.

41. Wong C, Samuel M, Tan B, et al. Capsular contracture in subglandular breast augmentation with textured versus smooth breast implants: a systematic review. Plast Reconstr Surg. 2006; 118: 1224-1236.

42. Pollock H. Breast capsular contracture: a retrospective study of textured versus smooth silicone implants. Plast Reconstr Surg. 1993; 91: 123-130.

43. Henriksen T, Holmich L, Fryzek J, et al. Incidence and severity of short term complications after breast augmentation: results from a nationwide breast implant registry. Ann Plast Surg. 2005; 54: 343-350.